Clear cell acanthoma - Misplaced Pages

Medical condition

Clear cell acanthoma

Clear cell acanthoma (Degos)
Specialty	Oncology

Clear cell acanthoma (also known as Acanthome cellules claires of Degos and Civatte, Degos acanthoma, and Pale cell acanthoma) is a benign clinical and histological lesion initially described as neoplastic, which some authors now regard as a reactive dermatosis. It usually presents as a moist solitary firm, brown-red, well-circumscribed, 5 mm to 2 cm nodule or plaque on the lower extremities of middle-aged to elderly individuals. The lesion has a crusted, scaly peripheral collarette and vascular puncta on the surface; in dermoscopy this looks like "a string of pearls". It is characterized by slow growth, and may persist for years. The clinical differential diagnosis includes: dermatofibroma, inflamed seborrheic keratosis, pyogenic granuloma, basal-cell carcinoma, squamous cell carcinoma, verruca vulgaris, psoriatic plaque, and melanoma.

Histology

Clear cell acanthoma is characterized by a sharply demarcated psoriasiform epidermal hyperplasia composed of a proliferation of slightly enlarged keratinocytes, and basal cells with pale-staining glycogen-rich cytoplasm, mild spongiosis and scattered neutrophils, which may form small intraepidermal microabscesses. Oedematous dermal papillae are typically seen with increased vascularity and a mixed inflammatory infiltrate including lymphocytes, plasma cells and neutrophils.

Treatment

Simple surgical excision is curative.

References

Tiodorovic-Zivkovic, D; Lallas A; Longo, C; Moscarella, E; Zalaudek, I; Argenziano, G (2015). "Dermoscopy of clear cell acanthoma". J Am Acad Dermatol. 72 (1 Suppl): S47-9. doi:10.1016/j.jaad.2014.06.039. PMID 25500041.
Odom, Richard B.; Davidsohn, Israel; James, William D.; Henry, John Bernard; Berger, Timothy G.; Clinical diagnosis by laboratory methods; Dirk M. Elston (2006). Andrews' diseases of the skin: clinical dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.

Skin cancer of the epidermis

Tumor

Carcinoma

BCC	Forms Aberrant Cicatricial Cystic Fibroepithelioma of Pinkus Infiltrative Micronodular Nodular Pigmented Polypoid Pore-like Rodent ulcer Superficial Nevoid basal-cell carcinoma syndrome
SCC	Forms Adenoid Basaloid Clear-cell Signet-ring-cell Spindle-cell Marjolin's ulcer Bowen's disease Bowenoid papulosis Erythroplasia of Queyrat Actinic keratosis
Adenocarcinoma	Aggressive digital papillary adenocarcinoma Extramammary Paget's disease
Ungrouped	Merkel-cell carcinoma Microcystic adnexal carcinoma Mucinous carcinoma Primary cutaneous adenoid cystic carcinoma Verrucous carcinoma Malignant mixed tumor

Benign
tumors

Acanthoma	Forms Large-cell Fissuring Clear-cell Epidermolytic Melanoacanthoma Pilar sheath acanthoma Seboacanthoma Seborrheic keratosis Warty dyskeratoma
Keratoacanthoma	Generalized eruptive Keratoacanthoma centrifugum marginatum Multiple Solitary
Wart	Verruca vulgaris Verruca plana Plantar wart Periungual wart

Other

Epidermal nevus	Syndromes Epidermal nevus syndrome Schimmelpenning syndrome Nevus comedonicus syndrome Nevus comedonicus Inflammatory linear verrucous epidermal nevus Linear verrucous epidermal nevus Pigmented hairy epidermal nevus syndrome Systematized epidermal nevus Phakomatosis pigmentokeratotica
Other nevus	Nevus unius lateris Patch blue nevus Unilateral palmoplantar verrucous nevus Zosteriform speckled lentiginous nevus
Ungrouped	Cutaneous horn

Category:

Epidermal nevi, neoplasms, and cysts

Histology

Treatment

See also

References